Mistakes in medical bills and claims denials are bad business for medical practices and could lead to a loss in reimbursement.
Many healthcare organizations see claims come back with an initial denial, which means they have to rework or appeal those claims, according to Becker’s Hospital CFO Report. Indeed, a 5% denial rate is average for practices, and there should be concern if their rate is above that level.
Here are four ways for physicians to reduce billing errors and ensure claims are paid:
Be sure patient data is correct. Denials occur when payers can’t identify the patient, so be sure policy numbers are accurate and names are spelled correctly, T. Scott Law, founder and CEO of Zotec Partners, told Becker’s.
Use technology to automatically and proactively flag claims that payers are likely to deny and fix problems before your practice submits them. Joseph T. Jenkins, M.D., a general surgeon with FACS of Tri-State Vein Center in Dubuque, Iowa, for instance, has reduced errors by using software that helps generate the note and check items in the electronic health record, says Medical Economics.
Keep staff up to date. The problem of billing errors at both small and independent practices is acute, Elvira Kasimova, billing department supervisor for the WCH Service Bureau, told Medical Economics. Practices need to conduct regular training about coding and billing updates and other changes.
Be aware of trends. Educate physicians about the top denials that occur in the practice on a weekly basis.